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Original article
Injury-related mortality among children younger than 5 years in China during 2009–2016: an analysis from national surveillance system
  1. Liangcheng Xiang1,
  2. Ke Wang1,
  3. Lei Miao1,
  4. Leni Kang1,
  5. Xiaohong Li1,
  6. Jun Zhu1,2,
  7. Juan Liang1,
  8. Qi Li1,
  9. Chunhua He1,3,
  10. Yanping Wang1,2
  1. 1 National Office for Maternal and Child Health Surveillance of China, West China Second University Hospital, Sichuan University, Chengdu, China
  2. 2 Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
  3. 3 Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
  1. Correspondence to Chunhua He, National Office for Maternal and Child Health Surveillance of China, West China Second University Hospital, Sichuan 610041, China; yanpingwang0618{at}163.com; Professor Yanping Wang, National Office for Maternal and Child Health Surveillance of China, West China Second University Hospital, Sichuan 610041, China; yanpingwang0618{at}163.com

Abstract

Background Epidemiology in injury-related mortality among children younger than 5 years was unreported in China recently.

Methods Data were obtained from China’s Under 5 Child Mortality Surveillance System (U5CMSS) in 2009-2016. Injury-related mortality rates were calculated by residence, age-group, gender and major injury type (drowning, traffic injuries, suffocation, poisoning, falls). The average annual decline rate (AADR) was calculated based on the annual mortality rates by Poisson regression and the relative risk (RR) between urban and rural residence was examined based on the rates of two years for each time point by Cochran-Mantel-Haenszel method.

Results U5CMSS contained 6503 injury-related deaths of children younger than 5 years during the study period, of which 58.6% were male, 86.0% occurred in rural areas, 65.7% were children aged 12–59 months. Deaths were mainly attributed to suffocation (34.3%), drowning (29.6%), traffic injuries (17.7%), falls (7.2%) or poisoning (4.7%). The injury-related mortality rate dropped from 274.7 to 189.2 per 100 000 live births from 2009 to 2016, giving an AADR of 4.53% (95% CI 3.50% to 5.55%). During 2009–2016, the injury-related mortality rate in rural area was higher than that in urban area, the adjusted RRs (aRRs) in infants and children aged 12–59 months were 3.32–6.04 and 4.31–5.49, respectively.

Conclusion The rate of injury-related deaths in children younger than 5 years has decreased in China, but it remains high and strong urban–rural disparities still exist. Public health programmes and policy interventions should focus particularly on suffocation among infants and on drowning and traffic injuries among children aged 12–59 months, especially in rural areas.

  • child
  • injuries
  • cause of death
  • mortality
  • epidemiology

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/injuryprev-2018-042853

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    Footnotes

    • LX and KW contributed equally.

    • Contributors CH and YW contributed to study design. All authors contributed to data acquisition. LCX and KW analysed the data and drafted the manuscript, which all authors revised and approved for publication.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Ethics approval Ethics Committee of West China Second University Hospital, Sichuan University.

    • Provenance and peer review Not commissioned; externally peer reviewed.